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Arthroscopic rotator cuff repair: patients with physically demanding work have significantly worse time to return to work, level of employment, and job loss

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to determine the results of arthroscopic rotator cuff repair (ARCR) in terms of return to work (RTW).

Methods

Inclusion criteria were working patients who underwent ARCR for rotator cuff rupture at the study site between 2008 and 2020 and minimum 12 months of follow-up. Patients were stratified based on the physical demand of their work according to the Canadian Classification and Dictionary of Occupations. The primary outcomes were time to RTW, level of employment (LoE), change of tasks, and work loss. Secondary outcomes included the return to sports activities, EQ-VAS, EQ-5D-5L, DASH, and Oxford Shoulder Score.

Results

Three-hundred and eighty-three patients were enrolled; at the follow-up evaluation, fifty-three patients (13.8%) lost their job, with a percentage of 34.4% (eleven patients) in the heavy-work category, and five patients (1.3%) chose early retirement. Other twenty-six patients (6.8%) had to lower their level of employment, and twenty patients (5.2%) changing their tasks, with 279 patients (72.9%) returning to their previous work activity. RTW was obtained at a mean time of 4.7 ± 4.6 months, ranging from 3.8 ± 3.1 months in the sedentary work vs 5.8 ± 2.8 months in the very heavy-work category (p = 0.015). The mean EQ-VAS score was 77.3 ± 18 points, the mean Oxford Shoulder Score was 43.4 ± 7.2 points, and the mean DASH score was 9.9 ± 14.5 points; 75.3% returned to their previous level of sport activity.

Conclusions

The success of ARCR in terms of RTW is not always complete and varies significantly based on the physical demand of the patient’s job. Patients with physically demanding work have a significantly higher time to RTW, reduction of the LoE, and job loss rate, thus affecting the possibility to have a satisfactory return to their previous life. The findings are of clinical relevance since they can help the surgeons to give their patients reliable expectations and to correctly plan the post-operative management.

Level of evidence

IV.

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Acknowledgements

The authors thank Elettra Pignotti, PhD, for her work in statistical analysis.

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Authors and Affiliations

  1. Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland

    Pietro Feltri, Andrea Stefano Monteleone, Francesco Marbach, Giuseppe Filardo & Christian Candrian

  2. Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland

    Giuseppe Filardo & Christian Candrian

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  1. Pietro Feltri
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  2. Andrea Stefano Monteleone
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  3. Francesco Marbach
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  4. Giuseppe Filardo
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Correspondence to Andrea Stefano Monteleone.

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Conflict of interest

Each author certifies that there are no funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article related to the author or any immediate family members. Christian Candrian has received institutional support outside the present work from Medacta International SA, Johnson & Johnson, Lima Corporate, Zimmer Biomet, and Oped AG.

Ethical approval

The local Ethical Committee of Canton Ticino approved the current study; the assigned number is Study 2021–00486/CE 3836.

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In accordance with the Swiss Law, every patient involved in the study signed an informed consent form, approved by the local Ethical Committee.

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Feltri, P., Monteleone, A.S., Marbach, F. et al. Arthroscopic rotator cuff repair: patients with physically demanding work have significantly worse time to return to work, level of employment, and job loss. Knee Surg Sports Traumatol Arthrosc 31, 153–160 (2023). https://doi.org/10.1007/s00167-022-07172-3

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